Pediatric Nursing: Cardiac Dysfunction

Pediatric Nursing: Cardiac Dysfunction

NUR 414

Normal Cardiac Anatomy and Function

• Familiarize yourself with normal blood flow patterns, including direction and pressure

• Be aware of the normal structure of the heart - right atrium and ventricle, left atrium and ventricle, etc.

• A good foundation of what's normal will allow you to better understand the altered hemodynamics of defects

Multiple Choice

Which of the following statements accurately describes pressures of the cardiovascular system in a child with normal cardiac structure and function?

• Systemic circulation pressure is higher than pulmonary circulation pressure; the left side of the heart has higher pressure than the right side.

• Pulmonary circulation pressure is higher than systemic circulation pressure; the left side of the heart has higher pressure than the right side.

• Systemic circulation pressure is higher than pulmonary circulation pressure; the right side of the heart has higher pressure than the left side.

• Pulmonary circulation pressure is higher than systemic circulation pressure; the right side of the heart has higher pressure than the left side.

Multiple Choice

What is the first important step in assessing an infant or child for possible heart disease?

• Assessing for environmental factors

• Taking an accurate health history

• Taking the infant or child's vital signs

• Assessing for autoimmune responses

Congenital Heart Disease

This next video clip will discuss some of the more common (or major) congenital cardiac defects. These are broken down by different classifications: increased pulmonary blood flow, decreased pulmonary blood flow, obstructive defects, and mixed blood flow defects

Multiple Choice

A child has a congenital cardiac malformation that causes right-to-left shunting. What clinical findings should the nurse expect?

• Peripheral edema

• Bounding pedal pulses

• Polycythemia

• Proteinuria

Multiple Choice

The nurse is caring for an infant with a cardiac malformation with left-to-right shunting. What clinical manifestation would the nurse immediately report to the provider?

• Spitting up after each feeding

• Oxygen saturation of 95%

• 6 wet diapers in 24 hours

• Crackles in the lungs and dyspnea

Acquired cardiac disease

Acquired cardiac disease can result from multiple causes - including infection, inflammation, anatomical defects, and more.

Multiple Choice

The nurse is caring for a child who has been admitted in the acute phase of Kawasaki disease. What intervention does the nurse anticipate?

• Eye drops for mucopurulent conjunctivitis

• IV placement for high dose antibiotics

• IV placement for administration of IVIG

• Administration of acetaminophen for fever

Multiple Choice

The nurse at the pediatric primary care office receives a call about a child with a history of mitral valve prolapse. The child is scheduled for a dental procedure, and the parent is wondering if anything needs to be done. The nurse anticipates:

• The child will need clearance from their cardiologist prior to the procedure.

• The child will need a one-time dose of prophylactic antibiotic against endocarditis.

• If the child has had a normal echocardiogram within the last year, they can have the procedure

• If the child has a normal ejection fraction, there is no need for prophylactic antibiotics.

Open Ended

What concepts are still unclear? We will address in class!